Humanitarian workers fear a further rise in novel coronavirus cases would be disastrous in northwest Syria, where almost 1.5 million people live in overcrowded camps or shelters, often with poor access to running water.

Health authorities in northwest Syria announced 5,075 cases of COVID-19 so far, including 42 deaths.

Of those, more than 860 cases have been recorded among healthcare staff and almost 330 people in the camps.

Of the three million people living in Idlib, nearly half live in makeshift homes and tents after escaping the fighting during Syria’s nine-year civil war.

In an informal settlement in Idlib, the country’s last major rebel stronghold, Hassan Sweidan, who fled his home seven years ago, said he and other displaced Syrians did not stand much chance against the disease.

“We live in a camp all crammed in together. If someone talks to his family, all the neighbours can hear it,” said Sweidan, who is in his 40s and has an existing health condition.

If someone gets sick “it’s hardly the disease’s fault”, the father-of-six added.

Sweidan said he hopes he does not have to take anyone in his family to the local hospital.

“Hospitals are overcrowded. People are now scared of doctors and nurses, who they think might be infected with all the sick people going to them.”

Sweidan especially fears catching coronavirus as he suffers from a chronic liver condition.

“One of my relatives got it a while back, and I’m really scared because I have no immunity,” he said.

Local and international humanitarian workers are working to contain the virus, but cases are still on the rise.

“In the northwest, confirmed cases have increased sixfold over the last month, with cases also rising in displacement camps and settlements,” Mark Lowcock, United Nations under-secretary-general for humanitarian affairs, told the UN Security Council on Tuesday.

At the Idlib health directorate, Dr Yahya Nehmeh said they had asked residents to observe social distancing.

But he admitted that was “near impossible” in the hundreds of informal settlements dotting the region.

Few in the camps wear masks. Many cannot afford to buy face coverings, or to change them regularly, let alone disinfectant hand gels.

For most, food, water, medicine and school supplies are far more important.